Month: January 2017

Can PMS Occur In The Middle Of Your Period?

Question: Can PMS occur during the middle of your period? Currently I’m in the middle of menstruation, and I’ve had mood swings, urges to cry and migraine/cramps for the past three days. Is this PMS related as it’s not before my period it’s during?

Moxie: PMS, mood swings, cramps, migraines, crying spells, and all the other horrible things PMS and PMDD bring are caused by estrogen levels falling too low. You will feel this way anytime your estrogen gets low which is usually right before your period but if you generally have low estrogen levels, you will feel like crap most of the time except those few days of your menstrual cycle when your estrogen is highest. Young women will have bi-polar-like behavior when their estrogen is low in their luteal phase, and feel good when estrogen higher in the follicular phase.

A horrible period means your estrogen is too low. If you had the right amount of estrogen, you wouldn’t have PMS or any of the symptoms associated with it. Your ovaries are under producing estrogen and the best way to get healthy menstrual cycles that are incident-free is to get out and move your body. Physical activity increases blood flow to our ovaries which in turn stimulates estrogen production. A crappy diet and poor sleep hygiene act as endocrine disruptors causing low estrogen production. Take care of your body. You have more control over how you feel than you think.  PMS is more of a choice of how you life your life.  

Perimenopause via Tubal Ligation

Most women don’t get the memo they will go into perimenopause if they get a tubal ligation. Over the last nearly 15 years working in the field of Hormone Medicine, I’ve been talking to women (and men) about hormones and hormone replacement therapies. Patients typically schedule a consultation with me before considering hormone therapy and I give them the run –down on what they can expect, what their responsibilities are, and what it might look like for them overall so they can make an informed decision as to whether hormone therapy is right for them and what kind. In this initial consultation, I listen to every patient as they give me their history of illness, symptoms, treatments, and medications. With hundreds of patients in a hormone specialty clinic, both men and women are quite frank about how they feel and what other providers have said to them. As with any field of specialty, complaints from patients tend to be the same and consistent from patient to patient and our patients are no exception.

Recently my cousin Claire reached out via text and asked if she could ask me a few questions regarding her health and Hormone Medicine. After reading her text messages out loud to a colleague, we looked at each other and smiled. We hear the same things from woman after woman no matter what her age is saying the exact same things. We chuckle because it’s almost verbatim as if they were all reading off the same script. Below is 38-year-old Cousin Claire’s random text messages indicating how miserable she is and what she tried to do about it. It’s not uncommon for women who’re low in estrogen to lose the ability to fluidly articulate the magnitude of how crappy they feel but this is a perfect example…

“On 1/4/16 I woke up very sick with a bad cold. Must have been some sort of infection because it wouldn’t go away so by February I went to the Nurse Practitioner. I was given a Z-Pak and told it was some type of bronchitis. After the round of antibiotics I still felt like crap but a bit better in March.  

In April I noticed my front teeth felt funny. It wasn’t until I felt some pain that I took note my front gums and lip were actually swollen. My regular dentist looked and took pictures and said maybe it’s an autoimmune problem. Another dentist a week later looked and said go to oral surgeon. Oral surgeon looked and said autoimmune.

Now I had awful headaches and couldn’t hardly function a full day at work. Exhausted and ended up with several panic attacks. Very unusual for me. Went to cardiologist and I have a very healthy heart, no concerns. I was tested for leukemia but that came back negative. Phew….    

I went to women’s health specialist who said they had no clue, but didn’t think it was hormonal in nature. I asked because I had my tubes tied two years ago and had missed a period. That also is weird.  

I had several blood tests all of which I could scan and email to you. Some thyroid stuff off but rheumatologist said no lupus (I had positive Ana test and symptoms that matched) and no thyroid disorder.

Finally got a new primary and she sent me to an Ear Nose & Throat specialist. They said I had an enlarged thyroid and needed to see an endocrinologist.   My symptoms are odd and off the wall. Just had another abnormal period. That is the short version of it…  

My symptoms: 

  • Swollen red gums
  • Severe headaches
  • Muscle soreness/pain not from exercising
  • Exhaustion
  • Foggy brain
  • Frequent nausea
  • No appetite
  • Depression
  • Anxiety attacks
  • Odd periods
  • Cramping to the point of feeling awful even when I didn’t have my period
  • Extremely dry, itchy skin

It feels like all the “specialists” I have seen think I’m crazy, except the dentist who believes me but can’t help me. I’ve been pushed from one person to another. My old primary told me this pain might be my new normal. I won’t accept it. This is not normal.

I think the exercise I do is the only thing keeping me from really getting too low. There are days and weeks that exercise is too hard and I can’t do it. But if I skip for too long my depression comes back too strongly. I’m obsessed with running and will at least do a mile if I can tie my sneakers. That is my happy place (that is when my chest pain – apparently fake – isn’t bothering me).”

It frustrates me how women have to deal with this like being on the exercise wheel of conventional medicine. The truth is doctors are purposely left in the dark with regards to what causes all these symptoms and what to do about it. The reality is every symptom, including her angioneurotic edema, is a result of estrogen deficiency.  When estrogen is right, none of these symptoms exist in our patients. As estrogen becomes healthy, each issue diminishes for most to nothing. Our modern medical model ships women from specialist to specialist as if we are all parts. There isn’t one function in the female body that estrogen does not affect so piece-mealing medicine doesn’t make sense. Every cell in a woman’s body depends on healthy levels of estrogen so when it gets too low, our body will fall apart all over the place, mentally, physically, and physiologically. If physicians were properly educated as to the true benefits of our main-sex hormones, it would be first-line therapy to check levels up front. Doing this would save time, money, medications, and mental and physical misery.

Tubal ligation will cause a woman to go into premature perimenopause within 1 to 3 years post surgery due to lack of blood flow to the ovaries.  Though tubal ligation does not directly affect estrogen production, reducing the blood supply to the ovaries will cause them to malfunction and not produce supercritical estrogen in health amounts.  Dysfunctioning ovaries under produce estrogen, if at all, leaving women estrogen deficient.   Women who are hormonally sound don’t feel the way Claire does. I tend to get a little giddy when I hear women tell me their stories because I know the impact their new hormone therapy will have on them over the next few months. They have no idea how much their lives are going to change. Their symptoms will go away and will feel alive again if done correctly. The greatest impact of intelligently administered hormones like Panacea|HRT is what it does to the brain of a woman. I can always tell by the look in a female patient’s eyes when she has plenty of estrogen running through her blood. It’s like the light goes back on.

Janet Jackson’s Postpartum Expectations


Janet Jackson’s birth.  It’s big news Janet Jackson gives birth at 50. The media is having a heyday with discussions of celebrity women in their 40s and 50s giving birth. Posted today in the Lifestyle-Beauty section of the news magazine The Telegraph is just such an article entitled, “As Janet Jackson announces the birth of her son, here’s what to expect from pregnancy in your late forties” about how wonderful it is for women to give birth as such a late age and what you can expect from pregnancy in your late 40s. No one really gives any good information in articles like this one, almost like the article was a link to current news for exposure with no real useful information. In this article, the unnamed author listed tips from fertility expert Emma Cannon who gives some generic pregnancy advise but no one really addresses what Janet Jackson can expect having a child at 50.

Though many think there’s no problem with a woman having a child at 50, there are some things a woman must truly consider with having a child at such a late age. Let me start with saying I’m surprised Janet was able to get pregnant at all. Women in their 50s typically have very low estrogen levels which is a big factor of whether a woman will get pregnant or not. Most ovaries have shut down adequate estrogen production, which makes it more difficult to get pregnant. A woman may be able to get pregnant at 50 but her estrogen will be so low after birth that her brain and body will not only not “bounce back” postpartum, but her estrogen production would be less than before she got pregnant, and continue a rapid decline until the tank is empty.

Women without enough estrogen are not tolerant, patient, or calm. They’re not teachable. They’re responses are out of proportion to the situation at hand. They have horrible migraines, headaches, and mood swings. They feel like the walking dead, can’t sleep and constantly crave bad carbs and refined sugar. They can’t remember anything and cry at everything. They’re not dependable and are augmentative.   Nothing makes an estrogen deficient woman happy. Nothing makes a woman without estrogen happy. Women without estrogen can’t stand the sound of children’s voices and have a difficult time emotionally connecting to others, including her own children. Estrogen deficient women are controlling, moody, and unpredictable. Women without estrogen are not happy campers to say the least. I would not want to be the child of an estrogen deficient women and no woman in her 50s has adequate levels of estrogen and it gets worse if she has children as her body is ready to throw in the reproductive towel.

Janet Jackson can expect to feel miserable mentally and physically if she doesn’t address her low estrogen issue she’s about to face in a couple months. When women have children in their early to mid twenties, their ovaries are more likely to kick back in with adequate estrogen production, making them better at being a mom. Depression and anxiety will be too much to handle.  It’s mentally and physically impossible to be a mom with no estrogen so the best thing Janet Jackson can do is find a good Hormone Medicine doctor who knows how to intelligently administer estrogen to optimal levels. This will allow Janet to bond with her son and not be at the mercy of her estrogen deficient brain and body falling apart.